Differences in family carer’s awareness of dementia caring support between Scotland and Japan
Problem
Family carers suffer from their caring burden, especially in dementia care. In Japan, family carers tend to shoulder most of the caring burden because of cultural norms, such as the expectation of providing family care at home. Although the Japanese government established new strategies to provide support for both people with dementia and family carers, the burden on family carers has been increasing because of shortened length of hospital stays and promotion of home caring.
Like Japan, Scotland is also an ageing society, and it supports family carers for people with dementia as a national strategy. Although care for dementia has been adequately provided and become widespread according to the national strategy, there has been little research on family carers’ recognition of available caring support.
This study aimed to clarify how family carers for people with dementia at home perceive caring support in Scotland and Japan.
Approach
This was a qualitative study which interviewed the key family carers in dementia home-caring environments in Scotland and Japan. Participants were recruited through convenience purposive sampling. We asked family carers how they felt about dementia care and the formal and informal care they received. The transcripts were analysed using ‘Steps for Coding and Theorisation’, a qualitative data analysis method. This study was approved by the Ethics Committee of Nagoya University School of Medicine.
Findings
Common perceptions of family carers for dementia in Scotland and Japan were 1) difficulty accepting dementia, 2) feeling a caring burden due to difficult dementia care, 3) hope for escaping from the caring responsibility and 4) interrole conflict among family carers. Family carers’ perceptions of each support were different and categorized into 3 types of providers: 1) subcarers, 2) community and 3) providers of care supports. In Scotland, support from the subcarers decreased the burden on the main carers because care roles were equal, clearly divided and cooperative. Family carers assumed a ‘Let it be’ attitude in announcing the dementia to the community, and they were satisfied with and trusted the providers of care support. In Japan, there was a difference in the awareness of dementia care among the family members because the care roles were ambiguous, sometimes uncooperative and unequal. Family carers were reluctant to let their community know about the dementia, and there was insufficient support for main carers from providers of care supports.
Consequences
Compared with Scotland, Japanese family carers are more frequently isolated. Thus, they tend to disclose their care experience to groups with similar care experience and peer support is more effective. It is expected that the comparison of two diverse countries’ awareness about dementia caring support can inform the development of quality dementia care worldwide.